Submission to the Medical Practitioners’ Board of Victoria On the Ethical and Clinical Practice Issues Around the Late Termination of Pregnancy

December 1997

The ACT Right to Life Association exists to protect the right to life of every human being, from conception till natural death. The Association urges the Medical Practitioners’ Board of Victoria to recommend against allowing late term abortions to be tolerated in Victoria.

Background

Few doctors in Australia practice abortion after the twentieth week of gestation. However, there is one doctor who has stated publicly that he would perform abortions as late as 28 weeks. [ Dr David Grundmann on the ABC Radio AM program, Thursday, 27 October 1994.]

The presence of a doctor or doctors willing to perform abortions to seven months’ gestation is of particular concern to the ACT Right to Life Association because of an attempt in the ACT in 1994 to remove all laws restricting the availability of abortion. [ Wayne Berry MLA introduced the Crimes (Amendment) Bill (No. 2) 1994 into the ACT Legislative Assembly on 24 August 1994. The Bill was drafted to remove all Crimes Act and common law offences for procuring an abortion, therefore allowing abortion at any stage of the pregnancy. The Bill lapsed when the term of the Assembly expired before the 1995 election.] There is the possibility, given the sponsor of the legislation concerned is now the leader of the opposition in the Assembly, that new legislation may be introduced after the ACT’s February 1998 election. Such legislation would create a climate which might encourage a late term abortion doctor to establish a business in Canberra, especially given the close proximity of Sydney, with a potentially large client base. Therefore the findings of the Medical Practitioners’ Board of Victoria may well be an important influence on any future debate in the ACT.

The timing of abortions

Although there is no ethical difference between taking the life of an unborn child at 10 weeks gestation or at 24 weeks gestation, given that the same child is just fourteen weeks more mature, there are some clear differences in public perception and significance between the two deaths.

In the case of late term abortions, the child is much more recognisably human and is similar in most respects, except size, to a recently born child. Indeed, if born prematurely, the child would be exactly the same.

Given that children born at 23 weeks’ gestation routinely survive outside their mother’s womb, and medical advances are likely to reduce this age of survival over time, it appears that some doctors are aborting children that can survive outside their mother.

Foetal pain

Although efforts are made to ensure that late term abortions are painless for the mother, there is no pain relief provided to the unborn child. [ David Grundmann, (1994) Abortion After Twenty Weeks in Clinical Practice: Practical, Ethical and Legal Issues. In John McKie (ed), Ethical Issues in Prenatal Diagnosis and the Termination of Pregnancy . Monash University Centre for Human Bioethics. Page 48.] One might think that, if there were a chance that the unborn child might feel pain, a doctor would err on the side of safety. There is ample evidence contained in a recent study that “…those anatomical structures subserving the appreciation of pain … are present and functional before the tenth week of life.” [ Peter McCullagh, Fetal Sentience , The All Parliamentary Pro-Life Group (UK), London, 1997. Page 5. Peter McCullagh is a Senior Fellow in Developmental Physiology at the John Curtin School of Medical Research, Canberra.] The presence of pain can only be more certain at later stages of life.

One Queensland abortion doctor also acknowledged that unborn children after twenty weeks of gestation would be capable of feeling pain. [ Dr Peter Bayliss in a report on the ABC TV 7.30 Report , 27 October 1994.]

It is interesting to note that the National Health and Medical Research Council has guidelines which state that “unless there is specific evidence to the contrary, investigators must assume foetuses have the same requirements for anaesthesia and analgesia as adult animals of the species.” [ National Health and Medical Research Council, Code of Practice for the Care and Use of Animals for Scientific Purposes .] It is a very poor reflection on the practice of abortion, and especially late term abortion where the possibility of pain seems most likely, that we place higher standards of protection on animals than we do on humans.

The nature of late term abortions

Despite attempts to paint late term abortions as acceptable and routine, human reactions often betray the truth behind the rhetoric.

A measure of the difference with which late term abortions are regarded is indicated in a recent National Health and Medical Research Council draft consultation document where it was noted that, in relation to a particular method of late term abortion, “D & E requires a greater degree of physician involvement and skill than the medical methods to be described later. Furthermore, the surgeon must be emotionally robust to perform a procedure requiring foetal destruction [emphasis added].” [ National Health and Medical Research Council, (1995) Services for the Termination of Pregnancy in Australia: A Review . NHMRC, Canberra. pp 69-70.]

In an article from the Medical Journal of Australia, the author notes that, when staff use foetal tissue obtained from induced abortions of unborn children ranging from 12 to 20 weeks’ gestation, “emotional reactions may occur on first handling the tissue, with some workers becoming tearful or having nightmares.” [ Bernard Tuch, (1993) Human fetal tissue for medical research. Medical Journal of Australia , vol.158, pp637-639.]

In an interview where Queensland abortion doctor Peter Bayliss was criticising a colleague, Dr David Grundmann, for performing abortions of unborn children over 5 months’ gestation, Dr Bayliss commented “it’s a gut churner. I don’t like it and my staff don’t like it.” [ ABC TV 7.30 Report , Thursday, 27 October 1994.]

The use of late term abortions to target disabilities

Addressing the ethical implications of late term abortions, Dr David Grundmann referred to the advances in prenatal diagnosis and asked “why invest so much money in pre natal diagnosis if we are not prepared to act on the results?” [ David Grundmann, (1994) Abortion After Twenty Weeks in Clinical Practice: Practical, Ethical and Legal Issues. In John McKie (ed), Ethical Issues in Prenatal Diagnosis and the Termination of Pregnancy . Monash University Centre for Human Bioethics. Page 50.] Dr Grundmann’s justification of late term abortions focused specifically on the disabled unborn child. This type of discrimination against disabled people is not unchallenged.

In November 1990 Disabled Peoples International (Australia) issued a critique of the National Health and Medical Research Council paper The Ethics of Limiting Life Sustaining Treatment. DPI said that having a disability is not inherently tragic and that it is presumptuous to assume that disabled people have a low quality of life and would be better off dead.

DPI said that “it is a particular tragedy that people should feel that there is so little social support and assistance, and that disability is so appalling that they should seek an abortion lest they raise a ‘defective’ child. Indeed, we question a social system which is prepared to fund the elimination and screening of people with disabilities, yet is not prepared adequately to fund the personal care and education services we need to lead autonomous, happy and successful lives in the community.”

“There appears to be an implicit acceptance of the existing inadequate level of support services for people with severe disabilities which leads to various low quality of life situations which are needlessly handicapping people with disabilities.”

“In terms of both decisions to abort foetuses and those decisions to withdraw life sustaining treatment from many neonates with disabilities, much of the decision making is not necessarily to do with the ‘right to choose’. Rather, it is to do with our Society’s reluctance to accept people with disabilities as full and whole people who are not necessarily condemned to a defective and sub-standard life.”

“… severe disability does not necessarily mean a tragic existence. Rather, it is inadequate and inappropriate support services which handicap people with disabilities and serve to create a low quality of life. With appropriate support, people with disabilities can go on to lead happy and productive lives pursuing their choice of lifestyle.” [ Christopher Newell, 1990, Lives of inestimable value: life worthy of life . Disabled Peoples International (Australia). Pages 13, 15, 16, 22.]

Conclusion

Late term abortions fail even the most cursory examination for signs of humane treatment of unborn children at a stage at which they are most clearly human beings and deserving of our respect and protection. Given the glaring inequities in the treatment we allow for children of the same age, depending on whether they are in their mother’s womb or outside, we urge the Medical Practitioners’ Board to find against late term abortions.

Abortion

ACT Right to Life

ACT Right to Life is a non-denominational, non-party political, voluntary community organisation established in 1972 to support the right to life of every human being from conception to natural death.